Skin immunity and its dysregulation in atopic dermatitis, hidradenitis suppurativa and vitiligo

Objective: To review the literature regarding the efficacy and safety of off-label use of apremilast in combination therapies for psoriasis and psoriatic arthritis and for other currently off-label inflammatory dermatoses. Methods: The Medline database was queried for all relevant articles published between 2014 and 2021 using exploded MeSH terms and keywords pertaining to the following themes: off-label, combination therapy, biologics, biologic therapy, methotrexate, and systemic psoriasis therapy. The Boolean term “AND” was used to find the intersection of these themes with the term “apremilast.” Results: 8 case series and 6 case reports investigated the use of apremilast in combination therapy for psoriasis and psoriatic arthritis. Addition of apremilast improved PASI scores by 31.8-77.4% among case series and 80-100% among case reports with adverse effects primarily consisting of gastrointestinal symptoms. 5 randomized-control trials (RCT), 9 open-label trials, 18 case series, and 30 case reports investigated the use of apremilast for off-label dermatoses. In RCTs, apremilast showed potential efficacy for atopic dermatitis and hidradenitis suppurativa. Open-label trials found apremilast efficacious for atopic dermatitis, allergic contact dermatitis, chronic pruritus, cutaneous sarcoidosis, discoid lupus erythematosus, hidradenitis suppurativa, lichen planus, prurigo nodularis, rosacea, and vitiligo. Limitations: Small sample size and short follow duration up for available randomized-control and open-label trials. Current data from case series/reports potentially limits generalizability of findings. Conclusion: Apremilast's safety profile makes it a potential efficacious, non-biologic systemic agent for monotherapy and combination therapy for a wide range of inflammatory dermatoses.

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LB1497 Association between hidradenitis suppurativa and atopic dermatitis

Journal of Investigative Dermatology ◽

10.1016/j.jid.2018.06.027 ◽

2018 ◽

Vol 138 (9) ◽

pp. B5

Author(s):

R. Kaakati ◽

R.A. Ward ◽

B. Liu ◽

C. Green ◽

T. Jaleel

Keyword(s):

Atopic Dermatitis ◽

Hidradenitis Suppurativa

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A case of Atopic dermatitis and Hidradenitis Suppurativa successfully treated with Dupilumab

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.16280 ◽

2020 ◽

Vol 34 (6) ◽

Cited By ~ 2

Author(s):

A. Gambardella ◽

G. Calabrese ◽

E. V. Di Brizzi ◽

R. Alfano ◽

G. Argenziano

Keyword(s):

Atopic Dermatitis ◽

Hidradenitis Suppurativa

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A systematic review on shared biological mechanisms of depression and anxiety in comorbidity with psoriasis, atopic dermatitis, and hidradenitis suppurativa

European Psychiatry ◽

10.1192/j.eurpsy.2021.2249 ◽

2021 ◽

Vol 64 (1) ◽

Author(s):

Michele Fabrazzo ◽

Salvatore Cipolla ◽

Simona Signoriello ◽

Alessio Camerlengo ◽

Giulia Calabrese ◽

...

Keyword(s):

Systematic Review ◽

Atopic Dermatitis ◽

Mental Disorders ◽

Hidradenitis Suppurativa ◽

Skin Diseases ◽

Killer Cell ◽

Cell Activity ◽

Biological Mechanisms ◽

Chronic Skin ◽

Chronic Skin Diseases

Abstract Background Mental disorders in comorbidity with chronic skin diseases may worsen disease outcome and patients’ quality of life. We hypothesized the comorbidity of depression, anxiety syndromes, or symptoms as attributable to biological mechanisms that the combined diseases share. Methods We conducted a systematic review based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement searching into PubMed, PsycInfo, and Scopus databases. We examined the literature regarding the comorbidity of psoriasis (Ps), atopic dermatitis (AD), or hidradenitis suppurativa with depression and/or anxiety in adults ≥18 years and the hypothetical shared underlying biological mechanisms. Results Sixteen studies were analyzed, mostly regarding Ps and AD. Brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling and nuclear factor kappa-light-chain-enhancer of activated B cells/p38 mitogen-activated protein kinase pathways arose as shared mechanisms in Ps animal models with depression- and/or anxiety-like behaviors. Activated microglia and neuroinflammatory responses emerged in AD depressive models. As to genetic studies, atopic-dermatitis patients with comorbid anxiety traits carried the short variant of serotonin transporter and a polymorphism of the human translocator protein gene. A GA genotype of catechol-O-methyltransferase gene was instead associated with Ps. Reduced natural killer cell activity, IL-4, serotonin serum levels, and increased plasma cortisol and IgE levels were hypothesized in comorbid depressive AD patients. In Ps patients with comorbid depression, high serum concentrations of IL-6 and IL-18, as well as IL-17A, were presumed to act as shared inflammatory mechanisms. Conclusions Further studies should investigate mental disorders and chronic skin diseases concurrently across patients’ life course and identify their temporal relation and biological correlates. Future research should also identify biological characteristics of individuals at high risk of the comorbid disorders and associated complications.

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Silver-coated textiles in hidradenitis suppurativa: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19845212 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1984521

Author(s):

Meggie Morand ◽

Afshin Hatami

Keyword(s):

Antimicrobial Activity ◽

Atopic Dermatitis ◽

Hidradenitis Suppurativa ◽

Skin Diseases ◽

Apocrine Gland ◽

Bacterial Proliferation ◽

Functional Textiles ◽

Systemic Antibiotics ◽

Pathologic Processes

Hidradenitis suppurativa is a chronic and debilitating skin disease of apocrine gland–bearing areas. The mainstay of treatment usually includes topical and systemic antibiotics. These agents can be used as monotherapy or combination therapy. The therapeutic role of functional textiles with antimicrobial activity has been recently emerging in the treatment of other skin diseases such as atopic dermatitis and epidermolysis bullosa. The pathologic processes involved in the development of atopic dermatitis and hidradenitis suppurativa are still incompletely understood, but these two diseases share some similarities including bacterial proliferation and chronic inflammation. We report the case of a 14-year-old boy with hidradenitis suppurativa that has been successfully treated with silver-coated textiles. To the best of our knowledge, this article is the first to report the benefits of silver-coated textiles in the treatment of hidradenitis suppurativa.

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Role of the microbiota in skin immunity and atopic dermatitis

Allergology International ◽

10.1016/j.alit.2017.08.004 ◽

2017 ◽

Vol 66 (4) ◽

pp. 539-544 ◽

Cited By ~ 34

Author(s):

Yuriko Yamazaki ◽

Yuumi Nakamura ◽

Gabriel Núñez

Keyword(s):

Atopic Dermatitis ◽

Skin Immunity

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Trunk and flexures

Paediatric Dermatology ◽

10.1093/med/9780198821304.003.0011 ◽

2020 ◽

pp. 151-158

Keyword(s):

Atopic Dermatitis ◽

Hidradenitis Suppurativa ◽

Pityriasis Versicolor ◽

Tinea Corporis ◽

Pityriasis Rosea

This chapter covers dermatoses which have a distribution on the trunk and flexures. The conditions are grouped into sections covering different morphologies. Red scaly truncal rashes include common conditions including eczema, pityriasis rosea, pityriasis versicolor, psoriasis, scabies, and tinea corporis, as well as rarer problems. Papular and pustular rashes and blistering disorders on the trunk are listed and signposted to other chapters for further detail. Lists are given for lumps, bumps, and other lesions, there is a similar list covering dermatoses according to their colours. The chapter concludes by covering flexural skin problems including hidradenitis suppurativa and intertrigo. While atopic dermatitis is mentioned, it is covered in more detail in Chapter 17.

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